Analysis Of The Relationship Between Clinical Characteristics Of Fatty Liver And Acute Pancreatitis

Objective: To analyze the correlation between fatty liver and acute pancreatitis(AP)severity in Yanbian area,so as to provide a reference for identifying high-risk AP patients in the early clinical stage.Methods: The clinical and laboratory data of 1991 patients with fatty liver and acute pancreatitis diagnosed in the affiliated Hospital of Yanbian University from January2015 to October 2020 were collected.They were divided into fatty liver patients,AP patients with fatty liver and AP patients without fatty liver.The clinical data and blood test data(including ethnicity,age,gender,weight,height,hypertension,diabetes,liver function,blood lipids,etc.)were analyzed statistically using SPSS software.Results:(1)Among the 1804 patients with fatty liver,alcoholic fatty liver disease accounted for32%,and non-alcoholic fatty liver disease accounted for 68%.The proportion of men was 59% and that of women was 41%.The proportion of Korean nationality was 47%,that of Han nationality was 51%,and that of other ethnic groups(Hui,Manchu,Mongolian)was 2%.The proportion of male and Korean in alcoholic fatty liver disease was higher than that in non-alcoholic fatty liver disease,and the difference was statistically significant(P < 0.05).(2)The ratio of hypertension in alcoholic fatty liver disease was lower than that in nonalcoholic fatty liver disease,and the difference was statistically significant(P = 0.005).Compared with < 45 years old and 45-59 years old groups,the proportion of alcoholic fatty liver disease in 60 years old and over was lower than that in non-alcoholic fatty liver disease,and the difference was statistically significant(P < 0.05).(3)Aspartate aminotransferase(AST),alanine aminotransferase(ALT),glutamyl transpeptadase(GGT),albumin/globulin(A/G),total bilirubin(TBIL),direct bilirubin(DBIL),Prealbumin(PA),creatinine(CREA),uric acid(UA)and triglycerides(TG)in alcoholic fatty liver disease were higher than those in non-alcoholic fatty liver disease,while age,AST/ALT,alkaline phosphatase(ALP),cystatin C(Cys C),and low density lipoprotein cholesterol(LDL-C)in alcoholic fatty liver disease were lower than those in non-alcoholic fatty liver disease.The difference was statistically significant(P < 0.05).(4)There was no significant difference in different degrees of pancreatitis between alcoholic fatty liver disease group and non-alcoholic fatty liver disease group(P=0.178).(5)The age of fatty liver + pancreatitis group was lower than that of non-fatty liver + pancreatitis group,but body mass index(BMI)was higher than that of non-fatty liver + pancreatitis group.The difference was statistically significant(P < 0.05).The ratio of male in fatty liver + pancreatitis group was higher than that in non-fatty liver +pancreatitis group.The difference was statistically significant(P < 0.05).There was no significant difference between Korean and Han nationality(P > 0.05).(6)Diabetes,obesity,total cholesterol(TC)abnormality and TG abnormality in fatty liver + pancreatitis group were higher than those in non-fatty liver + pancreatitis group,while biliary diseases,AST abnormality,ALT abnormality,albumin(ALB)abnormality,TBIL abnormality and DBIL abnormality in fatty liver + pancreatitis group were lower than those in non-fatty liver + pancreatitis group.The difference was statistically significant(P < 0.05).(7)Logistic regression analysis of the effect of fatty liver on different degrees of AP showed that unadjusted severe acute pancreatitis(SAP)and critical acute pancreatitis(CAP)were 3.058 times(95%CI:1.671-5.597)and 4.023 times(95%CI:1.588-10.190) times higher than those of mild acute pancreatitis(MAP),respectively.After adjusting for age,sex,diabetes,obesity,TC abnormality,TG abnormality,biliary disease,AST abnormality,ALT abnormality,ALB abnormality,TBIL abnormality and DBIL abnormality,fatty liver was still a risk factor for the progression of MAP to SAP or CAP.Conclusion:(1)Fatty liver patients with diabetes,obesity,and dyslipidemia are more likely to suffer from pancreatitis.(2)Fatty liver is an independent risk factor for the progression of mild acute pancreatitis to severe or critical acute pancreatitis.(3)Most of the patients with fatty liver are male,and the proportion of non-alcoholic fatty liver disease is high.The liver function damage of alcoholic fatty liver disease is more serious than that of non-alcoholic fatty liver disease.